Versed injection as a police weapon

NASHVILLE, Tenn. -- While the Metro police had banned the use of Tasers for a time, they still used a controversial method to subdue unruly people, according to an I-Team report.

The city's policy to use the method, which calls for the injection of a drug into a person, came as a "total surprise" to people most would expect to know all about it.

For almost two years, Metro police have had the option of calling for a needle loaded with a strong sedative to control the most unruly people they encounter on the street.

One of the doctors who came up with the protocol said it's the safest option out there and that it is used all over the country.

But many people said that the injection was news to them, and a top medical ethicist said it's a troubling precedent.

The drug is called Midazolam, which is better known as Versed. People who have had a colonoscopy have probably had a shot of the drug for the procedure.

"The drug has an amnesia effect, and we use that therapeutically because one of the nice ways to take care of the discomfort is to make people forget that they've had it," said biomedical ethics and law enforcement expert Dr. Steven Miles.

Wow, I've never heard such a thing before either. I'd be very concerned about shooting up people with drugs...you never know what adverse effects it might have. And, when it's an amnesic, it leaves you wondering about things like forced confessions the person won't remember later.

Wow, I've never heard such a thing before either. I'd be very concerned about shooting up people with drugs...you never know what adverse effects it might have. And, when it's an amnesic, it leaves you wondering about things like forced confessions the person won't remember later.

Really!! The dumb b*tch that administered the drugs ahead of my colonoscopy said things like "OK, here comes the sleepy medicine..." and I wanted to slap the condescending idiot. By the time the procedure was over, I might have kissed her as I was waking up, if she had asked nicely.

Wow, I've never heard such a thing before either. I'd be very concerned about shooting up people with drugs...you never know what adverse effects it might have. And, when it's an amnesic, it leaves you wondering about things like forced confessions the person won't remember later.

What troubles me is the guy that advocates its use and calls himself a biomedical ethicist. Personally I'd say its a violation of personal rights to inject any medication willy nilly like that absent consent. Not to mention the potential for wrongful death or consequential liability incurred by any adverse reaction or heaven forbid the transmission of aids to a defendant or even a police officer from a defendant coming out of some general brouhaha. in which a used needle inadvertently punctured another person.

Staff: Mentor

Slovis said the shots are given as a medical treatment, not a police function, even though ultimately they aid in an arrest.<snip>

"The decision to administer Versed is based purely on a paramedic decision, not a police decision," Slovis said.

It's up to the officer to call an ambulance and determine if a person is in a condition called excited delirium.

"I don't know if I would use the word diagnosing, but they are assessing the situation and saying, 'This person is not acting rationally. This is something I've been trained to recognize, this seems like excited delirium.' I don't view delirium in the field as a police function. It is a medical emergency. We're giving the drug Versed that's routinely used in thousands of health care settings across the country in the field by trained paramedics. I view what we're doing as the best possible medical practice to a medical emergency," Slovis said.

So it's not the police giving the injection. The police are calling paramedics and asking them to assess the individual and make the call.

They are recognizing the difference between someone just violent that needs to be thrown in the slammer and needs to be arrested and someone with a medical/mental condition.

The guy in the article that was treated was not charged by the police because they treated it as a medical issue instead.

Kalodimos reported that Beasley ended up at Metro General Hospital and was then put in psychiatric care. He was not charged in the incident on the bridge.

Personally, if I was flipping out, I would rather be treated by EMTs and given a sedative rather than be handcuffed and then thrown into a jail cell, especially if I was mentally incapactitated at the time. Medical care would by far be my preference.

Personally, if I was flipping out, I would rather be treated by EMTs and given a sedative rather than be handcuffed and then thrown into a jail cell, especially if I was mentally incapactitated at the time. Medical care would by far be my preference.

So we'll take this then as your medical release to be injected involuntarily if necessary, at the diagnosis and sole discretion of someone who is not a trained medical physician?

Staff: Mentor

So we'll take this then as your medical release to be injected involuntarily if necessary, at the diagnosis and sole discretion of someone who is not a trained medical physician?

Uhm, they "ARE" trained EMT's. Did you not read the article? The police are merely calling an ambulance and letting the EMT's take over. "THAT" is the change in the police policy. Police are now recognizing that some people may be having medical problems and calling for medical help instead of throwing the person into a jail cell. OY!

So we'll take this then as your medical release to be injected involuntarily if necessary, at the diagnosis and sole discretion of someone who is not a trained medical physician?

So I suppose you would prefer being forcibly restrained and hogtied if ever you have a mental break and let the cops just hope you don't injure yourself?

I've heard about this before and I don't find it all that suprizing or unethical. I wonder how many times police departments were sued for allowing a prisoner to inflict serious harm upon themselves before they were allowed this option.

Something similar, yet more unethical in my opinion, that I have learned about California law recently is that it is illegal to refuse a test of your blood alcohol content if pulled over by the police. If you refuse they arrest you, take you in, forcibly strap you down, and take your blood. Then, since you refused, you get to go to jail regardless of the outcome of the test.

Uhm, they "ARE" trained EMT's. Did you not read the article? The police are merely calling an ambulance and letting the EMT's take over. "THAT" is the change in the police policy. Police are now recognizing that some people may be having medical problems and calling for medical help instead of throwing the person into a jail cell. OY!

EMTs and paramedics aren't the same thing.

Regardless, using something like Versed in the field without a full medical evaluation is NOT good medicine. Paramedics are not diagnosticians, they are just there to get someone to the hospital for evaluation, and if the medication they are giving in the field could complicate the case or would hinder diagnosis (wait until it wears off before a proper psychiatric evaluation can be done, when you don't even know if it's the right drug for that patient), then it is NOT an ethical medical practice. Paramedics and physicians are not in the job of law enforcement. If they can hold someone still enough to give them an i.v. injection (that's how Versed is given), then they can hold them still enough to put restraints on them and transport them to the hospital for proper evaluation.

The really disturbing and concerning things in the story are parts like this:

"I woke up -- I don't know how much time had passed -- with a sergeant standing over me telling me to sign here. I didn't know what I was signing Ms. (Channel 4 I-Team reporter Demetria) Kalodimos. I just signed a piece of paper and was immediately right back out," he said.

This is probably the real reason this guy was never charged...they realized they wouldn't have a snowball's chance in hell of getting a court to consider evidence when they had someone signing forms without awareness of what they were signing. When someone is treated with Versed, they can look perfectly awake and aware, be capable of signing forms, giving confessions, etc., but really still be quite loopy and then never remember a bit of what happened while they were under the influence. If for some reason it's determined a person requires a shot of a narcotic out in the field, from the moment the injection is given, they should be treated as a patient with medical rights and under medical care and completely separated from police...no having police handing them forms to sign or trying to conduct interviews.

This is another concerning part:

Kalodimos reported that while doing research for this report, she found a post on a paramedics Internet chat site that said, "One good thing about Versed is that the patient won't remember how he got that footprint on his chest."

What if the reaction is an overreaction, and excessive force is being used? You've just rendered the person incapable of testifying against the officers. They damn well better be videotaping every moment of this if they have left someone unable to defend themself.

And, it's being used in situations contraindicated by the medication inserts, in other words, for off-label, non-FDA-approved uses. A physician can make that decision to prescribe a medication for off-label use, but will also be legally liable for malpractice if it turns out to be a bad decision. A paramedic should NOT be departing from SOPs for treatment...they are not trained to the level of making those sorts of diagnoses or judgement calls. If they need to depart from approved drug uses, it should ONLY be in consultation with a physician.

Staff: Mentor

In agreement with all you say, and perhaps a milder sedative would be more appropriate, I don't know what their reason for choosing Versed was. Do they need to sedate or completely knock the person out?

It's not ideal, but then, trying to take down a violent crazy person without them harming themselves or others never is. I would have to know more about exactly what the situation was before I could pass judgement. I could see this guy filing a lawsuit if they had thrown him in jail when he needed medical treatment.

I just know that of the two options, being mentally incapacitated and thrown in jail or being sedated and taken to the ER, I would choose the latter.

I would assume that Versed is only given in extreme cases, like the one mentioned in this article. Perhaps Berkeman can give us his perspective since he is an EMT?

Whats wrong with tasers? Its better than getting shot isn't it? Mase is still good too, why do police have to be so nice to criminals?

With enough adrenaline, meth, or speed in the blood stream; mace, bean bag shots, and even tasers are completely useless. You should never underestimate what people are capable of in a drasticly altered state of mind.

In agreement with all you say, and perhaps a milder sedative would be more appropriate, I don't know what their reason for choosing Versed was. Do they need to sedate or completely knock the person out?

It's not ideal, but then, trying to take down a violent crazy person without them harming themselves or others never is. I would have to know more about exactly what the situation was before I could pass judgement. I could see this guy filing a lawsuit if they had thrown him in jail when he needed medical treatment.

I just know that of the two options, being mentally incapacitated and thrown in jail or being sedated and taken to the ER, I would choose the latter.

I would assume that Versed is only given in extreme cases, like the one mentioned in this article. Perhaps Berkeman can give us his perspective since he is an EMT?

but how does this stuff help take down a violent crazy person? If it has to be given in an IV then they have already got the guy taken down. It's pretty difficult to get an IV in if the guy is jumping around like a mad man

Uhm, they "ARE" trained EMT's. Did you not read the article? The police are merely calling an ambulance and letting the EMT's take over. "THAT" is the change in the police policy. Police are now recognizing that some people may be having medical problems and calling for medical help instead of throwing the person into a jail cell. OY!

Sure I read the article. And it's a slippery slope you're playing on. You're citing an anecdotal about one case where one individual was seen to be in medical distress and they may or may not have been treated in a medically satisfactory way.

But what you lay bare and seem satisfied to deploy is a tool - the administration of drugs in the field - at the discretion of police and relatively untrained EMTs or paramedics - a system that relies on indeterminately trained individuals and the opportunity for abuse and misuse is far greater than immediate benefit.

How do you weigh a loss of life or reduction to vegetative state against the convenience of placing an individual under control with less effort? And if you think that judgment won't be made in the field then I think you have an idealized view of people placed in such positions.

How do you weigh the Hippocratic Oath against the convenience of momentary control? Just what is best for a patient? And who is to make that judgment? I see it as a very slippery slope, and hence I am quite surprised that the doctor quoted, would be so blithe about its use and so ready to call himself a biomedical ethicist.

With enough adrenaline, meth, or speed in the blood stream; mace, bean bag shots, and even tasers are completely useless. You should never underestimate what people are capable of in a drasticly altered state of mind.

And so into an indeterminate pharmaceutical cocktail already swirling in the blood stream, you are going to add another narcotic?

Into the maelstrom of a physical struggle you are going to ask someone to inject a dose?

There are too many things that can go wrong that far outweigh the things that can go right.